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Case Reports
. 2021 May 7:24:e01152.
doi: 10.1016/j.idcr.2021.e01152. eCollection 2021.

A fatal case of early prosthetic valve endocarditis caused by multidrug-resistant (MDR) - Sphingomonas paucimobilis

Aninka Saboe  1 , Yudri Adrian  1 , Leonardus Widyatmoko  2 , Melawati Hasan  1 , Charlotte Johanna Cool  1 , Yovita Hartantri  3 , Andri Reza Rahmadi  3 , Rama Nusjirwan  4 , Mohammad Rizki Akbar  1
Affiliations
Case Reports

A fatal case of early prosthetic valve endocarditis caused by multidrug-resistant (MDR) - Sphingomonas paucimobilis

Aninka Saboe et al. IDCases. .

Abstract

Sphyngomonas paucimobilis (S. paucimobilis) is a low-pathogenicity, gram-negative bacilli (GNB) that are previously known as an opportunist microorganism. Recent studies have shown that S. paucimobilis is an emerging pathogen causing various infections. Multidrug-resistant GNB has emerged as a major clinical and therapeutic dilemma in various hospital-associated infections. Although rare, S. paucimobilis could be associated with infective endocarditis (IE). Prosthetic valve endocarditis (PVE) is the most severe type of IE, which has high mortality rates despite diagnostic and treatment advances. We report a fatal case of early PVE associated with multidrug-resistant (MDR) - S. paucimobilis complicated with perivalvular abscess, complete heart block, valve detachment, and septic arthritis.

Keywords: Multivalvular involvement; Perivalvular extension; Septic arthritis; Sphingomonas paucimobilis; Valve dehiscence.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Transesophageal echocardiogram (TEE) before discharged showed good prosthetic mechanical MV position and functions.
Fig. 2
Fig. 2
(A) Echocardiography reveals multiple large vegetation at the edges of prosthetic MV (arrow); (B) Small vegetation at aorta (arrow); (C) multiple small undulating mass attached to septal tricuspid leaflet (arrow); and (D) MV detachment with left ventricular inflow obstruction (arrow).
Fig. 3
Fig. 3
Timeline of the patient's medical history, present illness, treatment, and outcome.
See this image and copyright information in PMC

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